Recent advances in inflammatory bowel disease

van Langenberg DR, Yelland GW, et al. Cognitive impairment in Crohn’s disease is associated with systemic inflammation, symptom burden and sleep disturbance. United European Gastroenterology Journal 2017; 5(4):579587. Patients with inflammatory bowel disease may suffer from cognitive dysfunction in addition to symptoms of diarrhoea and abdominal pain. Common complaints include impaired concentration and clouding of thought and they usually affect Crohns patients. A cross-sectional observational study has been conducted in order to measure cognitive impairment in Crohns patients compared to healthy controls. In this study, 49 Crohns clinic patients and 31 healthy control patients were asked to complete surveys including clinical, demographic, psychiatric, fatigue and sleep parameters. In addition, disease activity has been assessed for each Crohns patient using serum CRP, faecal calprotectin, HarveyBradshaw Index. A computer based test, The Subtle Cognitive Impairment Test (SCIT-RT) has been performed with the primary measure of response time and compared between both groups. Furthermore, multiple linear regression analyses incorporating all variables assessed for factors associated with slower SCIT-RT, indicating cognitive impairment (1). Crohns patients had higher depression scores and poorer sleep quality compared with healthy controls. Response times (SCIT-RT) were significantly slower in Crohns patients compared to healthy control group. The slowed response times were significantly correlated with clinical indices of inflammation including the Harvey-Bradshaw Index and serum CRP. This confirms a strong link between Crohns disease related congnitive impairment and systemic inflammation. However, there was an inverse correlation between intestinal mucosal inflammation and SCIT-RT as indicated by inverse correlation of faecal calprotectin and cognitive function. Poorer sleep quality remains strongly associated with cognitive dysfunction. Furthermore, this study reinforces that Crohns disease is a multisystemic condition with wide range of signs and symptoms (1).